Guidance

6 Recommendations for further research

6 Recommendations for further research

6.1 The committee considered that commissioning groups adopting the faecal immunochemical tests in primary care should audit their outcomes. Possible outcomes to audit include:

number of people referred using a suspected cancer pathway for an appointment within 2 weeks

number of people diagnosed with colorectal cancer

number of colonoscopies and CT colonographies requested.

The committee noted that Cancer Research UK is planning an audit in the south west of England to collect information on how people without rectal bleeding who have unexplained symptoms and are at low risk of colorectal cancer are assessed in primary care.

6.2 The committee considered that further research is needed to determine whether faecal haemoglobin levels are influenced by age, sex and medicines that increase the risk of gastrointestinal bleeding. It noted that these data could be used to further develop risk scores that include variables such as age, sex and symptoms to help determine pre-test probability. The data could also be combined with faecal haemoglobin concentration to refine management after the use of faecal immunochemical tests in primary care.

6.3 The committee noted advice from clinical experts that there is variability between the faecal immunochemical tests. This may affect the number of positive and negative results reported by the tests when a single threshold is used. It recommended further research to investigate the variability between technologies and encouraged the companies to make sure that results can be standardised for use in a symptomatic population.